Provider Demographics
NPI:1508201690
Name:SCOTT, KATHLEEN F (RN)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:F
Last Name:SCOTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MEGA LN
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-3711
Mailing Address - Country:US
Mailing Address - Phone:845-621-4321
Mailing Address - Fax:
Practice Address - Street 1:22 MEGA LN
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-3711
Practice Address - Country:US
Practice Address - Phone:845-621-4321
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2013-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY334831-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse